Why? Well, the answer involves a little study that made big news nearly two decades ago. A 1998 study by Andrew Wakefield found a link between Measles-Mumps-Rubella vaccinations and autism. While the study was later discredited, the findings continue to be touted by some, who feel that while the link isn’t proven, something about the vaccines causes autism. Jenny McCarthy and Holly Robinson Peete have been big proponents of not vaccinating, due to their perceived links between the vaccinations and autism.

Both have a child who was diagnosed with autism after receiving a vaccination.

Because enough parents are opting out of vaccination, diseases which had been under control are having regional outbreaks, such as whooping cough and measles. These disease are costly healthwise, and sometimes deadly to children, so a very real public health threat.

A Washington Post blogger said these anti-vaccine parents are endangering lives. Researcher Brendan Nyhan, in a piece for the New York Times, said his recent study finds that parents who are anti-vaccination become more entrenched the more information they are provided that contradicts their views. However, his research indicates doctors, if trained well, may be able to persuade some of these reluctant parents.

As a parent and a participant of a mother’s group whose read a lot about vaccination issues, I tend to think Nyhan is correct: pediatricians are key. Only pediatricians often make parents more entrenched, rather than persuade them of the benefits of vaccination.

Pediatricians should be at the forefront of the issue, as parents come to them for medical advice and treatment. However, pediatricians, seeing the overall public health costs of vaccines, often treat parents who have questions about vaccination with hostility and threats. Dr. Bob Sears, author of the Vaccine Book, notes on his website: “Most doctors around here kick patients out of their practice for not vaccinating, or for asking too many questions.”

Now that would be like a person going to a doctor, learning he suffered an affliction and when he asked questions about the proposed treatment, the doctor calling the patient foolish for having such questions and saying in no uncertain terms that the have to leave the practice if he didn’t want to follow the doctor’s advice.

Seems an extreme reaction. Yet this is the reaction that a fair number of doctors have when it comes to vaccines. It’s not helping the situation. In Nyland’s research on changing vaccination attitudes of parents, he found that most education efforts corrected misperceptions parents had about links between autism and vaccination, but didn’t increase the likelihood that parents would vaccinate. (The research was published in the journal Pediatrics; an early version is online here, as the Pediatrics article is only available to subscribers.) Given this, Nyland contends that doctors are the best source to help change doctors’ attitudes.

In the NYT piece, he writes, “A more promising approach would require parents to consult with their healthcare provider.... Parents name their children’s doctor as their most trusted source of vaccine information. That trust might allow doctors to do what evidence alone cannot: persuade parents to protect their children as well as yours and mine.”

I would agree. However, telling a patient they’re not welcome if they don’t vaccinate isn’t persuasion. It’s simply making parents doctor shop, which doesn’t increase childhood vaccination rates. Persuasion is about listening to concerns and addressing them. It’s about offering facts without offering a hostile adamancy that seems rehearsed and fake. Saying, “vaccines don’t cause autism” with all the vigor that Bill Clinton used when he said he did not have sex with that woman, produces the same believability results.

The primary concern parents are expressing when they hesitate or refuse to vaccinate is safety of their child. So, doctors should focus on that when talking to parents about vaccination. Explaining both the safety angle of vaccination, the dangers of the disease, and discussing the issue with the same respect they would any other health-related matter (high blood pressure, diabetes, smoking cessation), would be helpful.

Nadia Qureshi, MD, a pediatric infectious disease specialist at Loyola University Health System, notes that many parents view vaccinations as optional because they don’t see the diseases as harmful or untreatable. Nowadays, we vaccinate against diseases like the Chicken Pox, which many people (myself included) contracted as a child. Because of this parents associate all vaccines with comfort, rather than safety (even though some of these diseases can be deadly). In parents’ cost-benefit analysis, they worry about exposing their child to some unknown harm (autism, vaccine side effects) when they perceive the disease they’re vaccinating against as a known quantity that they simply take their child to doctor and it gets treated.

“Many people think it’s just a virus and my child will get better,” Qureshi said. “Unfortunately, it’s not as simple as that. This virus can make your child miserable and can lead to serious complications and even death.”

​Doctors who refuse to take time with their parents and issue ultimatums drive parents away when they should be doing the opposite, because the public health stakes are so high.

“Vaccine rates were so good in this country that many physicians have seen it in books or photos, but no live cases,” Qureshi said. “This can make it difficult to diagnose and people can be walking around with the contagious virus not even knowing it.”

Doctors have to remember that for patients, it’s about more than just the numbers, so citing study results doesn’t assuage people’s concerns. Most parents see themselves as the protectors of their child, not society at large, particularly people who choose not vaccinate. So, persuading them is going to have to focus on that, not big picture items (stopping mass outbreaks) that doctors and public health officials think of.

It’s important for doctors to figure out ways to address hesitant parents that deals with their concerns and moves them to vaccinate, otherwise we’ll see more outbreaks like in Ohio.